In the aftermath of the Nov. 13 stabbing death of a 29-year-old staff member at the state Department of Health, the state tightened security and increased staff-to-patient ratios, according to a news release.

The Department of Health “conducted a full safety and security review” of the State Operated Specialized Residential Program and Hawaii State Hospital facilities.

The state took “immediate action” to tighten security and increase staff-to-­patient ratios. All residents are screened with a pat-down, scanned with a metal detector and required to submit to urine drug testing.

Security patrols were increased, and the staff-to-­patient ratio was increased to 1-to-3 from 1-to-5, according to the state.

A four-day safety stand-down was instituted for both the SOSRP and the HSH to “review existing policies and procedures and recommend improvements to overall safety,” according to the state.

“These recommendations and improvements aim to create a safer and more secure environment within the hospital, prioritize patient care, and mitigate potential risks or issues that could compromise the safety and well­-being of patients and staff members,” Stephen Downes, director of communications for the Department of Health, told the Honolulu Star-Advertiser in a statement.

Specific recommendations in the report include:

>> Have the HSH report directly to the DOH deputy director of behavioral health.

>> Establish an assistant administrator for safety and operations, whose responsibilities include oversight of safety and security, reporting directly to the HSH administrator.

>> Establish a standing safety and security committee chaired by the assistant administrator of safety and operations.

>> Operations and facility improvements, but specifics were not shared.

>> Increase and enhance contracted security personnel, including a rapid response team, without sharing details about what those new staff members would be contractually obligated to do.

>> Relocate the guard shack lower on campus with a barrier across the street.

>> Repair and add cameras able to be remotely monitored.

>> Integrate the three public-address systems on the HSH grounds.